Individual
DR. GARY MARK WIEDEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2716 23RD AVE, GREELEY, CO 80634-6920
(970) 353-5300
(970) 353-5332
Mailing address
2716 23RD AVE, GREELEY, CO 80634-6920
(970) 353-5300
(970) 353-5332
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1689
CO
Other
Enumeration date
07/18/2006
Last updated
07/09/2012
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